Pancreatic Acinar Cell Carcinoma: Demographics, Treatment, and Survival Outcomes, A Retrospective Population-Based Study.

Objective: Pancreatic acinar cell carcinoma accounts for 1-2% of pancreatic tumors, with increasing frequency in recent years, and still represents a poor prognosis. This study aims to expand and update existing literature by analyzing national data gathered over almost two decades.

Methods: Data from 488 patients diagnosed with PACC in the Surveillance, Epidemiology, and End Results database were analyzed. This study employed the Cox regression method to compute hazard ratios and identify independent factors influencing survival. Additionally, Kaplan-Meier survival curves were utilized alongside the log-rank test.

Results: The median age was 64.7 years with male predilection (70.5%). "Poorly differentiated carcinoma" was the most common subtype (45.8%). The liver was the most common site of metastases (31.3%). The 5-year observed overall survival (OS) rate was 19.2% (95% CI, 14.9-23.8). The 5-year cause-specific survival (CSS) rate was 22.4% (95% CI, 17.7-27.5). Male gender has a 5-year OS of 19.2% (95% CI, 14.0-25.1) compared to female OS of 30.2% (95% CI, 20.7-40.1). Patients treated with multimodal therapy (surgery with chemoradiation) over only surgery or chemotherapy had better 5-year OS, 53.5% (95% CI, 31.8-71.0). Age > 60 and distant stage were independent factors associated with increased mortality.

Conclusions: Pancreatic acinar cell carcinoma is a rare, aggressive form of pancreatic cancer that primarily affects older adults. Our findings offer valuable insights to guide future clinical guidelines and tailored treatment strategies.